Recent research findings show an accelerated rate of absorption and heightened sensitivity to alcohol following bariatric surgery. Additionally, several alcohol-related automobile accidents and deaths have been reported following bariatric surgery. This literature supports earlier media reports suggesting significant changes in frequency of alcohol use and rate of intoxication from drinking alcohol. The combination of anecdotal and empirical evidence has led to the development of an "addiction transfer" model. This theory suggests that in the absence of the ability to use large amounts of food as a coping strategy, post-bariatric surgery patients may exchange this behavior for an alternative maladaptive behavior such as alcohol misuse. These findings have highlighted the current lack of knowledge in the field related to the frequency of alcohol use, the associated mood precipitants and consequences, and level of impairment following bariatric surgery. In the current study we propose to examine the use of alcohol in two groups of patients: pre-bariatric surgery patients and patients three to five years post bariatric surgery. We propose to study these patients with both laboratory and naturalistic assessment strategies in an effort to maximize control of the environment (laboratory assessment) and to assure ecological validity of the findings (naturalistic assessment). We believe that the proposed study will provide insight regarding the use of alcohol before and after bariatric surgery as well as valuable pilot data for a large scale, prospective, longitudinal study of the use of alcohol in a group of bariatric surgery patients. PUBLIC HEALTH RELEVANCE: The proposed project is particularly important to the understanding of changes that occur in the frequency of use, impairment, and antecedent and consequent conditions of alcohol use before and after bariatric surgery. Employing both laboratory and field assessment, the current study will provide both tightly controlled and naturalistic findings, which will be highly informative and clinically relevant to bariatric surgery patients.